Update on humanitarian health needs in Darfur
27 April, 2009 ¦ Health care for hundreds of thousands of people in Darfur remains severely threatened and the World Health Organization (WHO) is urging increased effort to improve access to services, prevent disease outbreaks and ward off malnutrition.
WHO is working to activate the Health Cluster and is working with the Government of Sudan and other United Nations (UN) and non-UN partners to strengthen health care services for people living in the three Darfur states.
A joint Sudan-UN assessment conducted 11–19 March has identified gaps that need to be filled following the expulsion of the 16 international and national nongovernmental organizations (NGOs) earlier that month. Gaps in the health and sanitation sectors are of particular concern with the upcoming rainy season.
More than 800 000 people are living in parts of the three Darfur states affected by the expulsions. Some 650 000 people do not have full access to the necessary range of health services. The Ministry of Health, WHO and Health Cluster partners are addressing the gaps. But supplies, salaries, and staff are in place only in some areas until the end of April. Additionally, the health surveillance system, linked to the disease outbreak early warning system, has been disrupted. Support has been requested from UN agencies (WHO and UNICEF) to finance the salaries and the service delivery efforts of the government .Humanitarian health actions carried out by the different stakeholders are seriously underfunded.
Meningitis cases have been confirmed throughout Darfur: 112 suspected cases (11 confirmed) in South Darfur, 13 cases (nine deaths) in West Darfur’s Jabel Marra area and six cases reported by the state Ministry of Health in North Darfur.
The joint Sudan-UN assessment noted that stop-gap efforts were under way including a one-time distribution of two-month food rations to 1.1 million people, the provision of potable water to some 850 000 people and expanded health services by the Ministry of Health through April. But critical gaps remain ahead of the rainy season, which may increase the spread of disease.
One of the effects of the expulsions was the closure of several health programmes operated by Médecins Sans Frontières, which has left gaps in health care delivery that must be filled. Two of MSF’s five sections have been forced to close, affecting nearly half of the NGO’s medical programmes in Darfur.
Since that assessment, WHO has expanded its analysis of the critical health gaps in the three Darfur states since the expulsions. The following are some results of such analysis:
In West Darfur:
- Of the 145 health staff providing care in 18 health facilities before the expulsions, now just one-third (63) are working;
- The sudden interruption of the community health care seriously affected immunizations, disease control and maternal and childhood health services;
- The expulsions completely disrupted emergency obstetrical care services and causing an increase in referrals for treatment;
- Some people displaced by the insecurity have said they can no longer obtain free health services due to the disruption of the system that provided health cards to internally displaced people;
- Laboratory services are not being provided in some areas;
- An increase of waterborne diseases could be expected and would directly be linked to the gaps created by expulsion of various NGOs involved in the water and sanitation sector.
In North Darfur:
- Recent violence in South Darfur forced more than 42 000 people to flee to Zam Zam in North Darfur by the end of March. State health authorities, assisted by WHO, UNICEF and UNFPA, has opened a temporary clinic in Zam Zam to care for the new arrivals.
In South Darfur:
- There has been a 25% reduction in health staff, dropping from 161 to 121 in 15 health facilities. Another five health facilities planned to be opened by NGOs are not functional;
- The NGO expulsions reduced emergency obstetrical care services in various localities;
- Three temporary health facilities have been set up around Kalma camp to provide basic health services and respond to the meningitis outbreak;
- The expulsion caused gaps in water supply, sanitation, solid waste management and hygiene promotion.
The health component of the 2009 Humanitarian Work Plan for Darfur remains seriously underfunded, with just 5% funding received for some US$ 80 million worth of health activities required. This work plan was drawn up before the March NGO expulsions, which have further increased health service needs in Darfur. WHO and its Health Cluster partners are jointly finalizing the priorities of actions needed to fill the most critical gaps.